In the world of evidence-based healthcare, the need for a systematic, rigorous, and inclusive review process has become increasingly vital. The JBI Convergent Segregated Approach is a widely used method in mixed-methods systematic reviews, especially when researchers aim to synthesize both qualitative and quantitative data. Developed by the Joanna Briggs Institute (JBI), this approach offers a way to maintain the integrity of different data types while still combining them for meaningful interpretation. Understanding how this method works, why it is used, and its application in research can help improve the quality and credibility of healthcare evidence synthesis.
Understanding the Convergent Segregated Approach
The JBI Convergent Segregated Approach is one of three core methodologies offered by the Joanna Briggs Institute for conducting mixed-methods reviews. The hallmark of this approach is the separate synthesis of qualitative and quantitative evidence, which are later brought together in an overarching synthesis. This method allows researchers to respect the methodological boundaries of each data type while still drawing integrated conclusions.
Unlike approaches that merge all types of data early in the review process, the Convergent Segregated Approach keeps them distinct until each has been thoroughly analyzed. This strategy is particularly helpful when the review question aims to explore not only what works (effectiveness) but also how and why an intervention works (context, perceptions, experiences).
Core Characteristics:
- Separate synthesis of qualitative and quantitative data
- Final integration conducted through a meta-synthesis or interpretive process
- Maintains methodological integrity for each data set
- Ideal for complex healthcare questions
Why Researchers Choose the Convergent Segregated Approach
In mixed-methods systematic reviews, integrating qualitative and quantitative data can be challenging. Many methodologies risk oversimplifying the findings by blending data types too early. The JBI Convergent Segregated Approach avoids this by allowing each dataset to be analyzed in its original form. Researchers often choose this method when their questions involve different layers of inquiry such as effectiveness and user experience, or clinical outcomes and patient preferences.
By keeping data streams distinct until the final synthesis, the approach supports a more nuanced and reliable conclusion. It gives equal weight to qualitative insights and quantitative measurements, making it especially valuable in patient-centered healthcare research and implementation science.
Stages of the Convergent Segregated Approach
1. Defining the Review Question
A successful mixed-methods review begins with a clearly defined question. In the Convergent Segregated Approach, the question often addresses both the effectiveness of an intervention and the experience of individuals affected by it. This dual focus guides the development of the inclusion criteria and the search strategy.
2. Identifying and Selecting Studies
Separate search strategies may be employed for qualitative and quantitative studies. Inclusion criteria should reflect the types of studies relevant to each synthesis. For example, randomized controlled trials may be selected for the quantitative component, while phenomenological studies may be chosen for the qualitative side.
3. Appraisal and Data Extraction
Each study is appraised for quality using tools appropriate for its methodology. Quantitative studies might be evaluated using statistical validity measures, while qualitative studies are reviewed for credibility and depth. Data extraction follows a parallel process for each dataset.
4. Independent Synthesis
This stage is the heart of the Convergent Segregated Approach. The two data types are synthesized independently using techniques best suited to each. For quantitative data, meta-analysis or narrative synthesis may be employed. For qualitative data, thematic synthesis or meta-aggregation is typically used.
5. Integration of Findings
Once both syntheses are complete, the results are combined during the integration phase. Rather than merging datasets directly, the findings are interpreted side by side. This can take the form of a matrix, framework, or narrative comparison that explores convergence, divergence, and complementarity in the results.
6. Drawing Conclusions
The final step involves interpreting the integrated results to form a comprehensive conclusion that addresses the full scope of the review question. This may inform practice recommendations, policy decisions, or further research.
Advantages of the Convergent Segregated Approach
The primary strength of this approach is its respect for the epistemological foundations of both qualitative and quantitative research. Rather than forcing one type of evidence to conform to another, the method allows each to contribute its unique strengths to the final synthesis.
Benefits Include:
- Preserves the integrity of distinct methodologies
- Provides a holistic understanding of complex healthcare issues
- Supports evidence-based practice with context-rich insights
- Allows researchers to address multifaceted review questions
Common Applications in Health Research
The JBI Convergent Segregated Approach is especially useful in areas such as nursing, public health, and implementation science. It is often used to assess not only whether an intervention works but also how it is experienced by patients or implemented by providers.
Examples of typical review questions include:
- What is the effectiveness of a telehealth intervention for managing diabetes, and how do patients experience it?
- Does community-based rehabilitation improve mobility outcomes, and what are the challenges in its implementation?
- Are mindfulness programs effective in reducing anxiety, and how do participants describe their experience?
Challenges and Considerations
While powerful, the Convergent Segregated Approach is not without challenges. Managing two separate syntheses requires significant time and expertise. There is also a need for clear, transparent reporting to ensure readers can follow the integration process.
Review teams often require diverse skills, including familiarity with statistical methods and qualitative analysis techniques. Moreover, synthesizing and integrating findings in a meaningful way requires careful interpretation and critical thinking.
Reporting Guidelines and Tools
To support transparency and rigor, JBI provides standardized tools and guidelines, including the JBI SUMARI software and the JBI Manual for Evidence Synthesis. These resources assist reviewers in following the proper procedures and documenting their methods clearly.
Reporting of results should follow recognized guidelines such as PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), with modifications for mixed-methods reviews when appropriate.
The JBI Convergent Segregated Approach stands as a robust and flexible framework for conducting mixed-methods systematic reviews. By allowing separate yet connected syntheses of qualitative and quantitative data, it provides a structured pathway to understand both effectiveness and lived experiences. Researchers across healthcare disciplines continue to adopt this approach for its ability to produce rich, credible, and actionable insights. As the demand for comprehensive, patient-centered evidence grows, the importance of methodologically sound approaches like this one will only increase, ensuring that healthcare decisions are informed by the full spectrum of available knowledge.